In the past, the use of endoscopic spine surgery was limited to intervertebral discectomy; however, recently, it has become possible to treat various degenerative spinal diseases such as spinal stenosis and foraminal stenosis. Nevertheless, as endoscopic spine surgery has developed and its indications have expanded, a wide variety of advanced surgical techniques have begun to be used, and consequently, the complications of endoscopic spine surgery have also increased. These complications vary depending on the treated area and the surgical method used. The most common complications include dural tear, radix injury, vascular damage, dysesthesia, infection, peritoneal or psoas hematoma, residual and recurrent disc, instability, and headache due to increased epidural pressure. To avoid these complications and to provide the necessary treatment when detected, careful surgical practice in appropriate indications and extreme sensitivity to complications are necessary.